Discussion 1

As the moderator, you will not submit traditional answers to the discussion board. Instead, you will engage in discussion with your peers from the perspective of a course leader or mentor. The nature of your interactions should be positive and invite further discussion that fosters creativity and expansion of the DNP role. Your responses and posts should be substantive in nature. A substantive post may include a question, sharing insight with scholarly reference, and helping students to interact with one another in creative ways.

Evaluate a culture/population of interest to assess a current need.

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Examples may include patients in various care environments, gender identity groups, racial identity, ethnic identity, etc.

Heart failure affects millions of people worldwide. The Centers for Disease Control (CDC) report, “…6.2 million adults in the United States have heart failure” (CDC, 2020, para 1).  For African Americans diagnosed with heart failure, the numbers are associated with more significant negative consequences. Blacks are 30% more likely to be diagnosed with heart failure. They are diagnosed at an earlier age and will die from the disease sooner than other races (U.S. Department of Health & Human Services, 2021).

Using the population/culture identified, devise a culturally sensitive response plan that addresses a specific need in that population. What objectives will you meet through this response plan?

Most heart failure patients are often overwhelmed or intimated by education presented in the hospitals. Lower rates of health care literacy are proportionally greater in blacks. Contributing to the black community’s low literacy rates is a belief system where negative topics are not discussed or claimed (A.S., personal communication, March 11, 2021). Lower socioeconomic status, access to healthcare, and a mistrust of the health care system also contribute to lower healthcare literacy rates and subsequent adverse clinical outcomes.

Effective management of this chronic debilitating disease depends on vigilant self-management involving knowledge and adherence of medication regimens, dietary restrictions, daily monitoring of weight, and symptom management. The Measure associated with heart failure addresses patient education and self-care elements by “…copy of written instructions or educational materials are given…” (Heidenreich, et al., 2020 p. 2). There was no requirement to assess learning.

After reading your textbook, consider the role of the DNP in education. Write an educational intervention plan that addresses your objectives. Using scholarly inquiry, discuss cost-effectiveness, feasibility, and the timeline for implementation of your plan.

Even with the emphasis of scientific evidence directing patient care, the combination of skill, formal education, personal integrity, and clinical experience cannot be underplayed. It is the combination of several types of knowledge that leads to the development of a nurse leader capable of positively influencing others in integrating healthcare services to achieve superior clinical outcomes and enhance the patient experience.

Patients are often discharged from health care facilities without proper evaluation of presented discharge materials, particularly instruction involving self-care. The teach-back method of instruction is a method to evaluate the understanding of written instructions. Yen & Leasure (2019) report use of teach-back method of patient instruction is associated with improved patient knowledge of self-care activities.

Associated implementation costs include printing of materials to reinforce the teach-back instruction. A survey would be given before and after instruction. Elements of the survey would include asking if the nurses are using the teach-back method, if the nurse’s evaluation of patient knowledge is improved and if the nurse’s self-confidence in providing instruction to the patients is improved.  The nurses’ instruction and related surveys could be given about six weeks. The desired outcome is that all patients with congestive heart failure receive education using the teach-back method.  Regardless of age, patient care environment, race, ethnicity, or gender identity, all patients would benefit from the verbal exchange of information regarding self-care activities. 

 

Center for Disease Control (2020). Heart Failure. 

https://www.cdc.gov/heartdisease/heart_failure.htm (Links to an external site.)

Heidenreich, P., Fonarow, G., Breathett, K.,  Jurgens, C., Pisani, B., Pozehl, B., Spertus, J., Taylor,K.,  Thibodeau, T., Clyde W. Yancy, C., & Boback Ziaeian, B., (2020). 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure. https://doi.org/10.1161/HCQ.0000000000000099Circulation: Cardiovascular Quality and Outcomes.

US Department of Health & Human Services Office of Minority Health (2021). Heart disease and African-Americans. 

https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=19 (Links to an external site.)

Yes, P., and Leasure, R. (2019). Use and effectiveness of the teach-back method in patient education and health outcomes, 36(6), pp. 284–289. Federal Practitioner

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